Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicenter, multinational, observational cohort study.
September 7, 2017Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, Chishti AS, Woroniecki R, Mammen C, Swanson JR, Sridhar S, Wong CS, Kupferman JC, Griffin RL, Askenazi DJ, Neonatal Kidney Collaborative (NKC). Lancet Child Adolescent Health. Sept 2017
In over 2,000 infants admitted to the NICU on IVF for at least 48 hours, 30% developed AKI based on the neonatal KDIGO definition. AKI varies by gestational age at birth: 48% for those born 22-29 weeks, 18% for 29-35 weeks and 37% for babies ≥ 36 weeks. Babies with AKI have higher mortality (OR 4.6, 95% CI 2.5-8.3) and longer length of hospital stay (8.8 days, 95% CI 6.1-11.5) after adjusting for multiple confounding factors.
doi: 10.1016/S2352-4642(17)30069-X
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Neonatal Acute Kidney Injury: A Survey of Neonatologists' and Nephrologists' Perceptions and Practice Management.
July 14, 2017Kent AL, Charlton JR, Guillet R, Gist KM, Hanna M5 El Samra A, Fletcher J, Selewski DT, Mammen C. Am J Perinatol. Jan 2018
Many knowledge gaps among neonatologists, and to a lesser extent, pediatric nephrologists were identified. Neonatologists were less likely to use categorical definitions of neonatal AKI (p <0.00001) or diagnose stage 1 AKI (p < 0.00001) than pediatric nephrologists. Guidelines for creatinine monitoring for nephrotoxic medications were reported by 34% (aminoglycosides) and 62% (indomethacin) of respondents. Nephrologists were more likely to consider follow-up after AKI than neonatologists (p < 0.00001). Also, 92 and 86% of neonatologists and nephrologists, respectively, reported no standardization or infrastructure for long-term renal follow-up.
doi: 10.1055/s-0037-1604260
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